Provider Demographics
NPI:1063803112
Name:TRAN MURRAY DENTAL CORPORATION
Entity type:Organization
Organization Name:TRAN MURRAY DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MY
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-997-7707
Mailing Address - Street 1:7545 W SAHARA AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2866
Mailing Address - Country:US
Mailing Address - Phone:702-997-7707
Mailing Address - Fax:702-932-9406
Practice Address - Street 1:5731 LA JOLLA BLVD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7302
Practice Address - Country:US
Practice Address - Phone:858-459-0229
Practice Address - Fax:702-932-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty